Professional Fee Coder

Welcome to Ovation Healthcare! 

At Ovation Healthcare (formerly QHR Health), we’ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions.  

The Ovation Healthcare and ruralMED difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare’s vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior.  

We’re looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare and ruralMED, you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork.  

Ovation Healthcare’s corporate headquarters is located in Brentwood, TN. For more information, visit www.ovationhc.com.

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The requirements listed below are representative of the knowledge, skill, and / or ability required:

Charge Entry:

• Receive and review charge entry data from practice sites.
• Identify and investigate incomplete or missing charges.

Coding:

• Abstracts clinical information; translates medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems.
• Sequences codes according to established guidelines.
• Thoroughly analyzes and interprets medical information, medical diagnoses, coding/classification systems, to ensure accuracy for prospective payment system reimbursement.
• Conducts training for physicians/staff on coding and or documentation practices.

Other:

• Maintains current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers.
• Maintains proficient knowledge of EHR, as well as any other systems, required for performing required job duties.
• Reviews and researches coding denials and advises on appeal verbiage/ coding changes.
• Communicates issues to management, including payer, system, or escalated account issues. Identifies medical necessity denial trends and provide suggestions for resolution.
• May perform other billing functions including claim submission, unpaid claims follow-up, denial resolution.
• Participates in department meetings, in-service programs, and continuing education programs.
• Maintains a professional attitude with patients, visitors, physicians, office staff and hospital personnel.  Assures confidentiality of patient information, maintaining compliance with policies and procedures.
• Performs other duties as assigned.